Mataya v. Delta Life Ins. Co.

71 So. 2d 139, 1954 La. App. LEXIS 626
CourtLouisiana Court of Appeal
DecidedFebruary 15, 1954
Docket19573
StatusPublished
Cited by8 cases

This text of 71 So. 2d 139 (Mataya v. Delta Life Ins. Co.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mataya v. Delta Life Ins. Co., 71 So. 2d 139, 1954 La. App. LEXIS 626 (La. Ct. App. 1954).

Opinion

71 So.2d 139 (1954)

MATAYA
v.
DELTA LIFE INS. CO.

No. 19573.

Court of Appeal of Louisiana, Orleans.

February 15, 1954.
Rehearing Denied March 29, 1954.

*141 Graham & Graham, New Orleans, for plaintiff and appellant.

Normann & Normann, New Orleans, for defendant and appellee.

McBRIDE, Judge.

This is a suit for recovery of the proceeds of a $500 insurance policy issued by defendant on the life of plaintiff's wife, who died suddenly on October 8, 1949, at her residence in New Orleans of "coronary thrombosis, diabetes (mellitus)." Plaintiff was named as beneficiary in the policy which bears the date of May 30, 1949. The insurer defends the action on the grounds that the insured was not in sound health at the time of making the application for the policy; that the insured intentionally deceived defendant by making false statements in the application as to her physical condition in that she represented that she had not consulted any doctor for professional services "during the past three years"; that said information was given by the insured to induce defendant to issue the policy; that such statements were false, all to the knowledge of the insured. The answer then goes on to aver that on or about May 12 and 13, 1949, and during the entire year of 1949, the insured had required medical treatment from her physician for diabetes and heart disease; that she was advised on May 12 and May 13, 1949, that she was suffering from heart disease and would require further treatment; that had the insured made a truthful and complete disclosure in the application as to her physical condition and the visitation and treatment by her physician. that defendant would not have issued the policy.

There was judgment below dismissing plaintiff's suit, from which plaintiff appealed. After hearing the matter, we reversed the judgment, holding that for as much as the policy was not one of industrial life insurance the special defenses were not available to the insurer, because the written application, not being attached to the policy, was inadmissible in evidence in view of Section 14.08 of Act 195 of 1948, LSA-R.S. 22:618. We decreed that plaintiff have judgment as prayed for against defendant. La.App., 58 So.2d 564.

On a writ of certiorari the Supreme Court examined into the validity of our decree and ultimately held that the policy involved was one of industrial insurance and that the special defenses could be urged by the insurer. Our judgment was reversed and the case was remanded to us for a consideration of the merits. 222 La. 509, 62 So.2d 817.

Arceneaux, defendant's, agent who received Mrs. Mataya's application for the policy, testified that he propounded the several questions contained in the application to Mrs. Mataya and filled in her answers exactly as she gave them. As reflected by the application, to the question "Are you now in good health?" Mrs. Mataya answered "Yes." To the question "What doctor have you consulted for professional services during the past three years?" her answer was "None."

The only evidence which can be said to support the special defenses emanates from defendant's witness, a Dr. A. H. Letten, the general medical examiner for another insurance company. The witness, as Mrs. Mataya's private physician, had occasion to treat her on May 12, 1949, at her home for a "cold" and "grippe condition." When Dr. Letten made the visit to Mrs. Mataya she was not confined to her bed; this was the only time Dr. Letten had ever seen her.

On direct examination the following question was propounded to the doctor:

*142 "Did you find any other symptoms present at that time?" He answered: "Not particularly, except that she looked sick, and I advised she be treated, come to see me, but I had never seen the lady since."

He then testified:

"Q. Did you recommend any specific type of treatment? A. Well, I thought she should have her heart taken care of, looked over generally, as we all should do as we advance along.
"Q. Did you see any symptoms present at that time which made you diagnose that it would be well to have the heart checked? A. Well, she was sick, and there was some edema, or puffiness.
"Q. Any blueness present? A. Just a little about the lips and sinus.

"Q. Did you also recommend a cardiogram for her? A. Yes.

"Q. Did she ever come up for examination? A. No.

"Q. —or any further treatments? A. None.

"Q. No electrocardiogram was ever made? A. No sir."

On cross-examination we find Dr. Letten's testimony to be:

"Q. Did you make any examination of her to determine whether she had heart trouble or not? A. Just superficially you can't determine that without the instruments we use to measure the heart. She might have had a condition.
"Q. You couldn't definitely tell whether she had heart trouble or not? A. No.

"Q. You couldn't tell. A. No.

"Q. When you speak of this edemic condition, what is that? A. Puffiness.

"Q. Was Mrs. Mataya a stout lady? A. Yes.

"Q. She was plump? A. Yes.

"Q. You just noticed her condition and thought perhaps she might be suffering from heart trouble? A. That's it, just to suggest she use precautions.

* * * * * *

"Q. But you didn't treat Mrs. Mataya for any heart trouble or any diabetic condition, did you? A. Definitely not.
"Q. And you didn't make any examination to determine whether or not she had actually such a condition? A. No, I had no facilities in the home for making such examination.
"Q. And you didn't call her to your office to make such an examination? A. No, I didn't call her, no; just suggested it.
"Q. Could you tell us definitely that during the entire year 1949, Mrs. Mataya had received treatment from a doctor for diabetes or heart disease? A. I wouldn't know of anything like that.

"Q. But you didn't treat her? A. No sir."

That Dr. Letten had never treated Mrs. Mataya for any ailment except the cold is also attested to by a letter signed by him, dated October 7, 1949, to this effect:

"10/7/49

"To whom it may concern:

"This is to certify that Mrs. R. Mataya was treated by me on May 12th and 13th 1949 for a severe cold. I have not treated her before nor since.
"Yours A. H. Letten, M.D."

We do not find it necessary to discuss Dr. Letten's evidence as the testimony speaks for itself. We need concern ourselves only with Mrs. Mataya's failure to disclose that she had been treated by Dr. Letten for the cold or grippe on May 12, 1949.

Section 14.09 of Act 195 of 1948, which was in force at the time the application *143 for the insurance was made (now LSA-R.S. 22:619), reads as follows:

"1. Except as provided in paragraph two of this section and section 15.02, no oral or written misrepresentation or warranty made in the negotiation of an insurance contract, by the insured or in his behalf, shall be deemed material or defeat or avoid the contract or prevent it attaching, unless the misrepresentation or warranty is made with the intent to deceive.
"2. In any application for life or health and accident insurance made in writing by the insured, all statements therein made by the insured shall, in the absence of fraud, be deemed representations and not warranties.

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Cite This Page — Counsel Stack

Bluebook (online)
71 So. 2d 139, 1954 La. App. LEXIS 626, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mataya-v-delta-life-ins-co-lactapp-1954.